Claims Examiner Senior \ Direct Placement60 - Contract TalentBurst, Inc.Claims Examiner Senior \ Direct Placement60 - ContractIrving, TX$23–$24 / hourThis role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Work claim projects resulting from overpayments or underpayments related to manual processing errors, benefit updates, and/or contract, fee schedule changes.
Dental Claims Resolutions Specialist CornerStone StaffingDental Claims Resolutions SpecialistIrving, TX$18.50–$19.50 / hourBy applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. • Submit corrected or rebilled claims with required documentation through NEA (National Electronic Attachments), clearinghouses, paper, or payer portals.
NewCasualty Claims Examiner ($2,500 Sign-On) GEICOCasualty Claims Examiner ($2,500 Sign-On)Dallas, TXWe’re in search of highly motivated Casualty Claims Examiners with prior casualty and bodily injury experience, in private passenger automotive liability claims, looking to help deliver world-class service to our clients. Negotiate claims settlements for evaluated damages with insureds, claimants and/or attorneys as assigned from letter of representation through settlement or verdict.
NewProperty Adjuster Specialist - Field CAT Claims USAAProperty Adjuster Specialist - Field CAT ClaimsDallas, TXRemote$74,240–$133,620 / yearProactively manages assigned claims caseload comprised of complex damages that require commensurate knowledge and understanding of claims coverage including potential legal liability. 2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
NewStaff Counsel - Liability Claims Forward AirStaff Counsel - Liability ClaimsCoppell, TXCertification/Licensure: Board Certification in Truck Accident Law approved by the American Bar Association (ABA) and offered through the National Board of Trial Advocacy (NBTA) preferred, Active license to practice law in good standing (or ability to obtain licensure as required for the role). Develop and execute litigation strategies aligned with organizational risk tolerance and financial objectives and work with outside counsel in all phases of litigation, including pleadings, discovery, depositions, motion practice, hearings, mediations, and trials.
NewProgram Manager - Airlines Exp Pinnacle Technical ResourcesProgram Manager - Airlines ExpFort Worth, Texas$65–$70 / hourContractorThe specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment. We are seeking a highly skilled Program Manager to lead and manage large-scale IT programs and enterprise project management initiatives.
NewMarketing Support Manager Pinnacle Technical ResourcesMarketing Support ManagerDallas, TexasContractorThe Marketing Support Manager will play a critical role in supporting the marketing team by managing day-to-day operations, coordinating campaigns, and ensuring the successful execution of marketing strategies. The specific compensation for this position will be determined by several factors, including the scope, complexity, and location of the role, as well as the cost of labor in the market; the skills, education, training, credentials, and experience of the candidate; and other conditions of employment.
NewManager Compliance - Compliance CHRISTUS HealthManager Compliance - ComplianceIrving, TXWork with business units to develop monitoring metrics, identify and provide input on department-level policies and procedures, as appropriate, and assist in developing/delivering specialized operational training for department Associates. Develop and deliver course content for targeted training initiatives as directed by the annual work plan or as identified through operational reviews or leadership requests.
NewTravel Nurse RN - Nurse Manager in Sunnyvale, TX Ambition 24HoursTravel Nurse RN - Nurse Manager in Sunnyvale, TXSunnyvale, TXJob Overview We are seeking an experienced Clinical Risk & Quality Improvement Director (RN) to lead hospital-wide quality improvement, patient safety, risk management, and regulatory compliance initiatives within an acute care hospital setting. This leadership role is responsible for overseeing quality performance programs, patient safety reporting, accreditation readiness, risk assessment activities, and clinical outcome improvement efforts.
NewDirector Litigation - Risk Finance CHRISTUS HealthDirector Litigation - Risk FinanceIrving, TXThe Litigation Attorney will provide timely response to claims, complaints, subpoenas and other service of process; legal research; review and drafting of pleadings and discovery responses, claim summaries, executive reporting, mediation/trial and other litigation-related events; e-discovery and legal holds management; and other activities under the supervision of more senior attorneys relating to all phases of litigation from pre-trial investigation through mediation, settlements, verdict or appeal. Work with VP of Litigation and other attorneys in the daily management of pre-litigation and litigation pertaining to a broad range of litigation, pre-litigation and other claim management matters for the entire enterprise including professional liability, general liability, regulatory matters and commercial litigation.
NewTrademark Associate Attorney Vaco LLCTrademark Associate AttorneyDallas, TX$310,000–$420,000Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to: the individual’s skill sets, experience and training; licensure and certification requirements; office location and other geographic considerations; other business and organizational needs. Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs.
Safety & Training Supervisor Summit School ServicesSafety & Training SupervisorCrowley, TXLicense or Certification: SBDI certification required; Commercial Driver’s License with Passenger and School Bus Endorsements required; Strong working knowledge of MS Office Software (Word, Excel, Outlook, PowerPoint, etc.) and transportation related software. Summit School Services companies share a strong commitment to provide the highest level of transportation safety, quality transportation, outstanding customer service and positive employee relations.
Accounts Receivable Lead SarnovaAccounts Receivable LeadDallas, TXThe A/R Management Lead also serves as a subject matter expert, identifying process improvements to increase efficiency within the A/R Management team, and acting as a resource to help team members resolve issues. Since its founding in 1984, Digitech has refined its software platform to create a cloud-based billing and business intelligence solution that monitors and automates the entire EMS revenue lifecycle.
NewStaff Engineer Fidelity InvestmentsStaff EngineerTrophy Club, TXRemoteInformation TechnologyPlease be advised that Fidelity’s business is governed by the provisions of the Securities Exchange Act of 1934, the Investment Advisers Act of 1940, the Investment Company Act of 1940, ERISA, numerous state laws governing securities, investment and retirement-related financial activities and the rules and regulations of numerous self-regulatory organizations, including FINRA, among others. Experience leading the Lifecycle of multiple concurrent solutions through strong communication skills, interpersonal skills, engaging with multiple functions, business analysis, architecture definition, POC creation, presentation skills, influential ability, and an ability to make progress despite ambiguity.
Commercial & Claims Manager Southland HoldingsCommercial & Claims ManagerGrapevine, TXFull timeThe Commercial & Claims Manager is responsible for contract administration related to the claims management process that includes review, negotiation, data collection, analysis, documentation and successful filing and negotiation of claims. Coordinates and oversees implementation of claims procedures and will work closely with Project Managers and Projects Engineers in gathering information required for claims submittals.
Manager, Claims Amtrust Financial Services IncManager, ClaimsDallas, TXThe WC Team Lead works with the Claim Adjusters to manage and ensure the Workers Compensation claims activities are being handled within the Amtrust Best Practices, develop and maintain professional customer and broker relations by identifying and meeting customer needs. Ensures that all AmTrust policies, procedures and controls are followed; also consults with the Claims Supervisors on claim areas needing improvement.
Claims Manager I Liberty Mutual Holding Company IncClaims Manager IPlano, TXWork with claims team and external attorneys to review coverages, investigate claims, analyze liability and damages, establish adequate indemnity and expense reserves, develop strategies and resolve claims, including, but not limited to direct participation in mediation and arbitration and active participation in settlement discussions. Please note, you will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Westborough, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Boston, MA; Las Vegas, NV; Plano, TX; Suwanee, GA; Chandler, AZ; or Weatogue, CT.
Claims Manager CorVel Enterprise Claims, Inc.Claims ManagerDallas, TX$87,190–$134,613 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
Commercial & Claims Manager Southland Holdings IncCommercial & Claims ManagerTXThe Commercial & Claims Manager is responsible for contract administration related to the claims management process that includes review, negotiation, data collection, analysis, documentation and successful filing and negotiation of claims. Coordinates and oversees implementation of claims procedures and will work closely with Project Managers and Projects Engineers in gathering information required for claims submittals.
Claims Manager CorVel CorpClaims ManagerDallas, TX$87,190–$134,613 / yearPay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. ABOUT CORVEL: CorVel, a certified Great Place to Work Company, is a national provider of industry-leading risk management solutions for the workers' compensation, auto, health and disability management industries.
Senior Claims Manager EPL - Remote Providence Health & ServicesSenior Claims Manager EPL - RemoteTXRemoteRequsition ID: 442190 Company: Providence Jobs Job Category: Financial Transactions Job Function: Health Plans Services Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 4008 SS RIS Address: CA Orange 1100 W Stewart Dr Work Location: St Joseph Hospital-Orange Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington.
Commercial & Claims Manager American Bridge CoCommercial & Claims ManagerTXRace/EthnicityDecline to answerHispanic or LatinoWhite, not Hispanic or LatinoBlack or African-American, not Hispanic or LatinoAsian, not Hispanic or LatinoNative Hawaiian or Other Pacific Islander, not Hispanic or LatinoAmerican Indian or Alaskan Native, not Hispanic or LatinoTwo or More Races, not Hispanic or LatinoMENA (Middle Eastern and North African). An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Excess Claims Manager Starr International Co IncExcess Claims ManagerTXAt Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Will be required to attend virtual and in person mediations and settlement conferences to negotiate cost-effective settlements, and potentially attend trials.
Senior Excess Claims Manager Starr International Co IncSenior Excess Claims ManagerTXAt Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex. Will be required to attend virtual and in person mediations and settlement conferences to negotiate cost-effective settlements, and potentially attend trials.
NewMgr Liability Claims Dallas Area Rapid TransitMgr Liability ClaimsDallas, TexasMay be moderately exposed to unpleasant working conditions to include dust, noise, temperature, weather, petroleum products, and chemicals while visiting DART's operating facilities, assuming incumbent is observing all policies and procedures, safety precautions and regulations, and using all protective clothing and devices provided. Valid Texas A, B, or C drivers license, no Driving While Intoxicated (DWI) conviction within the last sixty (60) consecutive months, not more than one (1) DWI on driving record, and not more than three (3) convictions of moving violations within the last thirty-six (36) consecutive months in order to operate DART non-revenue vehicles.
Claims Supervisor CorVel Enterprise Claims, Inc.Claims SupervisorDallas, TX$71,696–$110,701 / yearPart timePay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries.
NewClaims Team Manager, Commercial Casualty Liberty Mutual Holding Company IncClaims Team Manager, Commercial CasualtyPlano, TXPlease note, you will be required to go into the office twice a month if you reside within 50 miles of one of the following offices: Boston, MA: Westborough, MA; Hoffman Estates, IL; Indianapolis, IN; Lake Oswego, OR; Las Vegas, NV; Plano, TX; Suwanee, GA; Tampa, FL; or Weatogue, CT. Provides management oversight of claims files (non-litigated or litigated) within the unit, to include Manager Reviews on open inventory and reviews files to measure quality assurance discusses individual training and development needs.
Claims Manager, Commercial Auto Starr International Co IncClaims Manager, Commercial AutoDallas, TXProviding management oversight to Third Party Administrators commercial auto property damage and bodily injury claims personnel by monitoring the claims online using the Third Party Administrators' claim systems. At Starr, you'll work in an entrepreneurial culture alongside accessible leaders, leveraging our financial strength and vast industry experience to deliver solutions for our clients, no matter how complex.
NewClaims Team Manager - Total Loss AAAClaims Team Manager - Total LossCoppell, TexasWith our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team. Lead meetings in collaboration with unit management to communicate goals with direct reports and reinforce/monitor behavior that furthers technical and customer service performance expectations.
Manager - Construction Claims Markel Group IncManager - Construction ClaimsTX$97,520–$134,090 / yearThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. Pay information: The base salary offered for the successful candidate will be based on compensable factors such as job-relevant education, job-relevant experience, training, licensure, demonstrated competencies, geographic location, and other factors.
Claims and Risk Manager Northstar Energy Solutions, LLC.Claims and Risk ManagerGrand Prairie, TXThe Claims & Risk Manager is responsible for leading NorthStar Energy Solutions’ incident-to-claim lifecycle, working directly with the Safety and Regional Risk teams to assess, manage, and influence claim outcomes. This role applies adjuster-level expertise to evaluate incident severity, determine exposure, and ensure all claims are supported by accurate, thorough, and defensible documentation.
Claims and Risk Manager Quanta Services IncClaims and Risk ManagerGrand Prairie, TXThe Claims & Risk Manager is responsible for leading NorthStar Energy Solutions' incident-to-claim lifecycle, working directly with the Safety and Regional Risk teams to assess, manage, and influence claim outcomes. This role applies adjuster-level expertise to evaluate incident severity, determine exposure, and ensure all claims are supported by accurate, thorough, and defensible documentation.
NewSenior Manager, Software Engineering - Claims CollectiveHealth IncSenior Manager, Software Engineering - ClaimsPlano, TX$200,000–$250,000 / yearTechnical and People Leadership: Guide the team in building scalable, cloud-native backend services and integrations using our tech stack (Java/Spring Cloud, Kafka, AWS, Kubernetes, PostgreSQL) and Business Rules Management Systems (BRMS). Drive AI & Agentic Development: Lead the team''s adoption of AI-powered developer tools (e.g., GitHub Copilot, Cursor, WindSurf) and drive architectural decisions for building AI-native, Agentic solutions (utilizing tools like LangChain or Google ADK).
Core Claims Project Manager Merit RestorationsCore Claims Project ManagerDallas, TX$60,000Work from scopes provided by Merit Estimators; adjust and refine as needed to meet project requirements, timelines, and budgets. Build and sustain strong relationships with insurance carriers, adjusters, homeowners, and subcontractors.
Auto Claims Operations Manager - Scanner Ops PDR-Team IncAuto Claims Operations Manager - Scanner OpsLewisville, TX$70,000–$80,000 / yearWe are hiring a Technical Operations Manager to own Colibri scanner operations in the U.S. This role is hands-on and travel-ready: deploy the scanner to job sites, keep it running (maintenance + troubleshooting), and train others. Strong technical affinity — proven ability to quickly learn and independently operate new hardware and software systems.
Manager, Claims Data Analytics GEICO GENERAL INSURANCE COMPANYManager, Claims Data AnalyticsDallas, TXGEICO is looking for a highly motivated, innovative, and detailed leader to fill the role as a SIU Manager in enterprise fraud analytics who has a passion for managing individuals and building a best-in-class analytics and reporting suite. Must have the following education and experience: Must have 3+ years experience managing leadership associates while being responsible for the development, execution and outcomes of business plan initiatives.
Claims Supervisor CorVel CorpClaims SupervisorDallas, TX$71,696–$110,701 / yearExcellent written and verbal communication skills • Ability to assist team members to develop knowledge and understanding of claims practice • Effective quantitative, analytical and interpretive skills • Strong leadership, management and motivational skills • Demonstrated, strong customer service skills • Ability to maintain composure under pressure and communicate diplomatically across various channels, including telephone, email, and written correspondence • Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Excel spreadsheets • Strong interpersonal, time management and organizational skills • Ability to work both independently and within a team environment • Knowledge of the entire claims administration, case management and cost containment solution as applicable to Workers' Compensation. • Bachelors degree or a combination of education and related experience • Demonstrated public speaking skills • Minimum of 5 years claims handling experience • Knowledge of WC required • Current license or certification in Workers' Compensation must be maintained throughout employment with CorVel • Self-Insured Certificate preferred • State Certification as an experienced Examiner.
Workers Compensation Claims Specialist CinemarkWorkers Compensation Claims SpecialistPlano, TexasThis exciting and important role will be integral in ensuring Cinemark’s Workers’ Compensation claims process is aligned with industry best practices, fits the company culture and business strategy, and provides great value to our team members. 7+ years of hands-on Workers’ Compensation adjusting experience, managing claims within a Risk Management Department or the Claims Department of an insurance carrier or Third-Party Administrator.
Program Claim Manager, Commercial Liability AmTrust Financial Services, Inc.Program Claim Manager, Commercial LiabilityDallas, Texas$87,600–$120,000 / yearFull timeThe successful candidate will evaluate coverage issues and risk transfer opportunities as well as ensuring appropriate investigations of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, and proper negotiation strategy is employed. Ensuring appropriate investigations of the underlying facts and circumstances is carried out, proper experts are retained and utilized where necessary, selection and utilization of counsel is appropriate, proper negotiation strategy is employed.
Senior Claims Specialist, Cyber Markel Group IncSenior Claims Specialist, CyberTXThis includes race; color; sex; religion; creed; national origin or place of birth; ancestry; age; disability; affectional or sexual orientation; gender expression or identity; genetic information, sickle cell trait, or atypical hereditary cellular or blood trait; refusal to submit to genetic tests or make genetic test results available; medical condition; citizenship status; pregnancy, childbirth, or related medical conditions; marital status, civil union status, domestic partnership status, familial status, or family responsibilities; military or veteran status, including unfavorable discharge from military service; personal appearance, height, or weight; matriculation or political affiliation; expunged juvenile records; arrest and court records where prohibited by applicable law; status as a victim of domestic or sexual violence; public assistance status; order of protection status; status as a smoker or nonsmoker; membership or activity in local commissions; the use or nonuse of lawful products off employer premises during non-work hours; declining to attend meetings or participate in communications about religious or political matters; or any other classification protected by applicable law. • Manage litigation filed nationwide against insureds; appoint, direct and manage defense counsel; proactively work toward expeditious and economical resolution of claims; assist Company claims vendor management, disbursement and legal collections teams with defense counsel, bill payment and collection issues.
Claims Examiner - Workers Compensation VytwoClaims Examiner - Workers CompensationDallas, TXRemoteExcellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations. To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Claims Supervisor - TX Workers Compensation Claims GallagherClaims Supervisor - TX Workers Compensation ClaimsCarrollton, TexasRemoteFull timeThe actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. Required Qualifications: • High School Diploma • Minimum of 10 years related claims experience • Appropriately licensed and/or certified in all states in which claims are being handled • Knowledge of all team member related functions Desired: • Bachelor's Degree .
NewClaims Director(WC & TPA Oversight) CNA Financial CorpClaims Director(WC & TPA Oversight)Plano, TX$97,000–$189,000 / yearJOB DESCRIPTION: Essential Duties & Responsibilities: Performs a combination of duties in accordance with departmental guidelines: Leads the work activities of claims professionals and/or claims managers and has full management responsibility for setting and communicating expectations, providing direction and coaching, facilitating ongoing training and development, managing employee performance and contributing to employee engagement. This director-level role operates under general direction with broad authority to lead the oversight of complex, high-exposure commercial Workers' Compensation claims managed by Third-Party Administrators (TPAs), while also managing and developing a team of claim professionals.
AVP, Claims- Personal Lines Hallmark Financial ServicesAVP, Claims- Personal LinesDallas, TexasThe AVP will provide oversight to all personal lines units and supervisors/managers responsible for adjusting 1st and 3rd party auto bodily injury and property damage claims; including collision, comp, total losses, salvage, subrogation, PIP, SIU and litigated claims. This position will oversee claims adjudication, drive process improvements using technology, ensure regulatory compliance, manage budgets, and lead teams to deliver timely, accurate, and cost-effective claims processing.
Senior Claims Adjuster, TPA Oversight The Fortegra Group IncSenior Claims Adjuster, TPA OversightTX$100,000–$130,000 / yearThe Senior Claims Adjuster, TPA Oversight will provide technical expertise and handle a wide variety of severity/complex claims as well as coverage litigation within Commercial Auto, Cargo, and Crane & Rigging lines of business. Additionally, they will complement the existing Specialty Claims team that supports the Underwriting unit and will provide oversight of third parties and delegated authority referrals.
General Liability Claims Specialist Amtrust Financial Services IncGeneral Liability Claims SpecialistDallas, TXThe Claims Specalist is responsible for the prompt and efficient examination, investigation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds and claimants, ensuring that company resources are utilized in a cost effective manner in the process for General liability claims within BI. Determines, reviews and analyzes coverages that may or may not apply to the claim; Plans, executes and reviews investigations-coverage, liability and/or damages - including the securing of a signed or recorded statement of the insured, claimant and/or witnesses.
Private Client Claim Manager IMA Financial GroupPrivate Client Claim ManagerDallas, KansasIn addition to our robust benefits package, the final offer amounts will depend on a variety of factors, including the candidate’s geographic location, prior relevant experience, and their knowledge, skills, and abilities. Our plans are cost-effective, convenient and provide progressive ways for staying healthy, protecting loved ones, pursuing financial security and living a full and balanced life.
Claims Examiner Senior \ 160 Paladin Consulting, Inc.Claims Examiner Senior \ 160Irving, TX$22–$23 / hourThis role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing. Summary:The Claims Examiner Senior is responsible for reviewing, analyzing, researching, and resolving complex medical claims in accordance with claims processing guidelines and desktops, as well as, ensuring compliance with federal regulations.